Severity Of Covid-19 And Survival In Patients With Rheumatic And Inflammatory Diseases: Data From The French Rmd Covid-19 Cohort Of 694 Patients

Aeschlimann Florence, Ait-Abdallah Nassim, Albert Jean-David, Alcais Didier,Allanore Yannick, Amador-Borreiro Blanca,Amoura Zahir, Andre Emma, Arlet Jean-Benoît,Arnaud Laurent, Arniaud Denis, Arty-Hue Herliette,Atlan Lucie, Audoin-Pajot Christine, Audren Victor,Avouac Jérôme, Bach-Bunner Maxime, Bacquet-Deschryver Hélène,Bader-Meunier Brigitte,Balandraud Nathalie, Balblanc Jean-Charles,Bally Stéphane, Banal Frédéric,Banneville Béatrice, Barnetche Thomas, Barrelet Audre, Basch André, Baumier Vincent, Bayer Guillaume, Bayle Sophie, Belin Véronique, Belkhir Rakiba, Benainous Ruben,Belot Alexandre, Benammar Mohammed, Benhamou Mathilde, Benhamou Ygal, Benmansour Ahmed, Bennet Pascal, Bernoux-Manat Brigitte, Berthoux Emilie, Bertolini Ewa, Bisson-Vaivre Aurélia, Blaison Gilles, Bolla Gilles, Bonidan Olivier, Bonnet Christine,Borie Raphaël, Boudou Laurence, Bouhour Françoise,Bouiller Kévin, Bouldoires Bastien, Boussoualim Karima, Bouvard Eric, Brondino Regine, Buchlin Pierre,Cacoub Patrice, Carteni Maurizio, Carbasse Aurélia, Castel Brice, Cathebras Pascal, Caumont Hervé, Celant Annalisa,Chaigne Benjamin, Chaillous Benoît, Champy Romuald, Charcot Agnès,Charles Pierre, Charlot-Lambrecht Isabelle,Chatelus Emmanuel, Chaudier Bernard,Chazerain Pascal, Chertok Pascale, Chevalier Xavier, Chevreau Maxime, Chotard Emilie, Chu Miow Lin,Claudepierre Pascal,Clavel Gaëlle, Clavel-Osorio Cyril, Cohen Fleur, Cohen Gregory, Colette-Cedoz Marie-Eve,Collercandy Nived, Colombey Antoine, Comarmond Chloé,Combe Bernard, Comparon Céline, Constant Elodie, Corre Clémence,Costedoat-Chalumeau Nathalie, Couret Marie, Courvoisier Natacha, Coury-Lucas Fabienne, Coutarel Cécile, Coutier Fabrice, Damade Richard, Daver-Malaterre Laurence, Dehimat Sarahe, Delahousse Michel, Descamps Elise, Deslandre Chantal, Desmurs Marie, Despaux Jacques, Desplats Marie, Detree Frédérick,Devauchelle-Pensec Valérie,Devaux Mathilde,Dhote Robin,Dieude Philippe, Dieudonne Yannick, Diot Elisabeth, Direz Guillaume, Djeddi Djamal-Dine,Domont Fanny, Drouet Béatrice,Drumez Elodie, Duc Catherine, Ducornet Angélique, Dufauret-Lombard Carine,Duhamel Alain, Dumaine Cécile, Dumel Anne-Elisabeth, Durand Géraldine,Duret Pierre-Marie,Ebbo Mikaël,Ebstein Esther, Economu-Dubosc Andra,El Mahou Soumaya, Euvrard Romain, Evon Philippe, Fabre Sylvie, Fauconier Marion,Fautrel Bruno, Fechtenbaum Jacques,Felten Renaud, Fernandes Fanny, Ferreira-Maldent Nicole, Feurer Elodie, Fichet Amandine,Flaisler Françoise,Flipo René-Marc, Florens Nans, Foltz Violaine, Fontanges Elisabeth, Foret Jennifer, Fougerousse Anne-Claire, Fouque-Aubert Anne, Foutrier-Morello Catherine, Francois-Pradier Hélène, Frantzen Léa, Fritz Pierre, Froissart Antoine, Fulpin Jean, Fuzibet Piera, Gaches Francis, Gagneux-Lemoussu Laurence, Gahier Penhoat Mélanie, Galland Joris, Gandjbakhch Frédérique, Garnier Nicole, Garraud Thomas, Garrot Jean-François, Gastaldi Romain, Gaud-Listrat Véronique, Gauthier-Prieur Maud, Georgescu Dana,Georgin-Lavialle Sophie, Gerard Nathalie,Gervais Elisabeth, Gibert Christelle, Gibert Eric, Gill Ghislaine, Gillard Jérôme, Gilson Mélanie, Grenoble Gimonnet Pauline, Giraudet-Le Quintrec Jeanine-Sophie, Giraud-Morelet Aude, Glace Baptiste, Glanowski Camille,Godeau Bertrand, Gombert Bruno, Gonnet-Gracia Camille, Goulenok Tiphaine,Goupille Philippe, Gourmelen Olivier, Govindaraju-Audouard Sophie, Grados Franck, Grardel Bruno, Grasland Anne, Grateau Gilles, Groza Monica, Guillaud Constance, Guillaume Séverine, Guillot Xavier, Guilpain Philippe, Gury Aline,Guyot Marie-Hélène,Hachulla Eric, Hacquard-Bouder Cécile, Havard Marie-Noelle, Hellier Jean-Pierre, Hennequin Pascal, Henriot Basile, Henry Julien,Hentgen Véronique, Hermet Marion, Herasse Muriel,Hie Miguel, Hittinger-Roux Ambre,Hudry Christophe, Huguenel Serge,Jaccard Clara, Jacquemier Jean-Michel, Jamard Bénédicte, Jan Catherine, Jean Sylvie, Jouvray Mathieu, Juge Pierre-Antoine, Juillard Laurent, Jullien Denis, Kabala Anna, Kabchou Abdelkrim, Karkowski Ludovic, Karman Françoise, Kemiche Farid, Keraen Jérémy,Kone-Paut Isabelle, Koreichi Abdeldajallil, La Batide Alanore Sylvain,Lafforgue Pierre, Lahalle Sophie,Langlois Vincent, Lanot Sylvain, Lanteri Aurélia, Larbre Jean-Paul, Latourte Augustin, Le Guen Guegan Sophie, Le Guenno Guillaume, Lebrun Agnès, Ledoult Emmanuel, Legoupil Nathalie, Legrand Erick, Lejeune Charlotte, Leloire Olivier, Leroux Christophe,Leroy Rémi, Leturcq Tifenn, Liote Frédéric,Lohse Anne, Lucas Virginie, Madelon Aurélie,Mahevas Matthieu, Maillard Hélène, Maillet Thibault, Malochet-Guinamand Sandrine, Mangon Quentin, Marchou-Lopez Sylvie, Margarit Nathalie, Marhadour Thierry, Maria Alexandre, Mariette Xavier,Marotte Hubert,Mathian Alexis, Maurier François, Maury Frédéric, Mazet-Guillaume Betty, Mazouyez Arnaud Angers, Contamine-Sur-Arve Mazyad Hassan, Mehsen-Cetre Nadia,Meinzer Ulrich,Mekinian Arsène,Melki Isabelle,Messer Laurent, Michaud Martin, Michon Mathilde, Milesi-Lecat Anne-Marie, Molto Anna, Moly Marie, Moranne Olivier, Morel Gautier,Morel Hugo, Morel Jacques, Morin Franck, Moulinier Laurence,Moulis Guillaume, Moura Bertrand, Nguyen Minh, Nicolas-Vullierme Sabine, Nielly Hubert, Nocturne Gaétane, Ollagnon Henri-Olivier, Pacaud-Vitoux Isabelle, Charpin Caroline, Parrot Antoine,Pascart Tristan, Pascaud-Mansour Yasmina, Paulin Lætitia, Pavy Stephan, Perard Laurent,Pers Yves-Marie,Pertuiset Edouard,Pha Micheline,Pham Thao, Pichon Maud, Argenteuil Pizana Gabrielle, Poix Elsa, Portier Agnès,Pouchot Jacques, Poulet Antoine, Plassard Samira,Pugnet Grégory, Puyraimond-Zemmour Déborah, Quartier-Dit-Maire Pierre, Quenet Marion, Remy Philippe,Renard Myriam,Rene Jessica, Revuz Sabine, Richard-Colmant Gaëlle,Richez Christophe,Riviere Etienne, Riviere Sébastien, Robin Sophie, Rohmer Julien, Roitg Isabelle,Romier Mélanie, Rolland Michel, Roriz Mélanie, Rossi Linda, Roth Olivier,Rouidi Sid-Ahmed, Roumier Mathilde, Rousiere Mickaël, Rousselin Clémentine, Roux Christian, Roux Fabienne, Roux Marielle, Roux Nicolas,Rouzaud Diane, Rozenberg Sylvie, Sacco Isabelle, Sadji Fatiha, Sailler Laurent, Salliot Carine,Salmon Jean-Hugues, Schmidt Jean, Seguier Julie,Sellam Jérémie, Senbel Eric, Sene Thomas, Senet Patricia,Seror Raphaële,Servettaz Amélie,Seve Pascal, Sicaud Aurélie, Smets Perrine,Sobanski Vincent,Sordet Christelle, Sornay-Rendu Elisabeth, Souchaud-Debouverie Odile, Sparsa Lætitia, Steib Sarah, Strotz Victor, Szafors Paulina, Taffignon-Clave Séverine, Simoens Justine, Tenenbaum Nora, Thomachot Benoît,Thomas Thierry, Tieulie Nathalie, Tison Alice, Toussirot Eric, Trefond Ludovic, Trijau Sophie, Trouillier Sébastien, Veillard Ericveillard Marie-Eliseeric, Veillard Eric, Veillon Laurent,Vial Guillaume, Viallard Jean-François,Victor Judith, Vidon Claire, Vidon Mathias, Vigne Camille, Virone Alexandre, Warzocha Ursula,Wendling Daniel, Werle Claude, Willems Alexandra, Wisniewski Michel, Woessner Juliette,Xerri-Campano Bernadette

ANNALS OF THE RHEUMATIC DISEASES（2021）

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Objectives There is little known about the impact of SARS-CoV-2 on patients with inflammatory rheumatic and musculoskeletal diseases (iRMD). We examined epidemiological characteristics associated with severe disease, then with death. We also compared mortality between patients hospitalised for COVID-19 with and without iRMD.Methods Individuals with suspected iRMD-COVID-19 were included in this French cohort. Logistic regression models adjusted for age and sex were used to estimate adjusted ORs and 95% CIs of severe COVID-19. The most significant clinically relevant factors were analysed by multivariable penalised logistic regression models, using a forward selection method. The death rate of hospitalised patients with iRMD-COVID-19 (moderatesevere) was compared with a subset of patients with non-iRMD-COVID-19 from a French hospital matched for age, sex, and comorbidities.Results Of 694 adults, 438 (63%) developed mild (not hospitalised), 169 (24%) moderate (hospitalised out of the intensive care unit (ICU) and 87 (13%) severe (patients in ICU/deceased) disease. In multivariable imputed analyses, the variables associated with severe infection were age (OR=1.08, 95% CI: 1.05-1.10), female gender (OR=0.45, 95% CI: 0.25-0.80), body mass index (OR=1.07, 95% CI: 1.02-1.12), hypertension (OR=1.86, 95% CI: 1.01-3.42), and use of corticosteroids (OR=1.97, 95% CI: 1.09-3.54), mycophenolate mofetil (OR=6.6, 95% CI: 1.47-29.62) and rituximab (OR=4.21, 95% CI: 1.61-10.98). Fifty-eight patients died (8% (total) and 23% (hospitalised)). Compared with 175 matched hospitalised patients with non-iRMD-COVID-19, the OR of mortality associated with hospitalised patients with iRMD-COVID-19 was 1.45 (95% CI: 0.87-2.42) (n=175 each group).Conclusions In the French RMD COVID-19 cohort, as already identified in the general population, older age, male gender, obesity, and hypertension were found to be associated with severe COVID-19. Patients with iRMD on corticosteroids, but not methotrexate, or tumour necrosis factor alpha and interleukin-6 inhibitors, should be considered as more likely to develop severe COVID-19. Unlike common comorbidities such as obesity, and cardiovascular or lung diseases, the risk of death is not significantly increased in patients with iRMD.

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